Differentiating irritable mood and disruptive behavior in adults
Trends psychiatry psychother. (Impr.)
;
42(4): 375-386, Oct.-Dec. 2020. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-1145189
ABSTRACT
Abstract Introduction Irritability has both mood and behavioral manifestations. These frequently co-occur, and it is unclear to what extent they are dissociable domains. We used confirmatory factor analysis and external validators to investigate the independence of mood and behavioral components of irritability. Methods The sample comprised 246 patients (mean age 45 years; 63% female) from four outpatient programs (depression, anxiety, bipolar, and schizophrenia) at a tertiary hospital. A clinical instrument rated by trained clinicians was specifically designed to capture irritable mood and disruptive behavior dimensionally, as well as current categorical diagnoses i.e., intermittent explosive disorder (IED); oppositional defiant disorder (ODD); and an adaptation to diagnose disruptive mood dysregulation disorder (DMDD) in adults. Confirmatory factor analysis (CFA) was used to test the best fitting irritability models and regression analyses were used to investigate associations with external validators. Results Irritable mood and disruptive behavior were both frequent, but diagnoses of disruptive syndromes were rare (IED, 8%; ODD, 2%; DMDD, 2%). A correlated model with two dimensions, and a bifactor model with one general dimension and two specific dimensions (mood and behavior) both had good fit indices. The correlated model had root mean square error of approximation (RMSEA) = 0.077, with 90% confidence interval (90%CI) = 0.071-0.083; comparative fit index (CFI) = 0.99; and Tucker-Lewis index (TLI) = 0.99, while the bifactor model had RMSEA = 0.041; CFI = 0.99; and TLI = 0.99 respectively). In the bifactor model, external validity for differentiation of the mood and behavioral components of irritability was also supported by associations between irritable mood and impairment and clinical measures of depression and mania, which were not associated with disruptive behavior. Conclusions Psychometric and external validity data suggest both overlapping and specific features of the mood vs. disruptive behavior dimensions of irritability.
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Assunto principal:
Humor Irritável
/
Transtornos de Deficit da Atenção e do Comportamento Disruptivo
/
Transtornos do Humor
/
Comportamento Problema
/
Transtornos Disruptivos, de Controle do Impulso e da Conduta
Tipo de estudo:
Estudo prognóstico
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Trends psychiatry psychother. (Impr.)
Assunto da revista:
Psiquiatria
Ano de publicação:
2020
Tipo de documento:
Artigo
/
Documento de projeto
País de afiliação:
Brasil
/
Estados Unidos
Instituição/País de afiliação:
National Institute of Mental Health/US
/
Universidade Federal do Rio Grande do Sul/BR
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